In a recent case, a former employer was required to reach a deal with the NJ Attorney
Click here to read: Franklin Lakes business owner must mortgage home to avoid jail in workers compensation case
Showing posts sorted by relevance for query uninsured. Sort by date Show all posts
Showing posts sorted by relevance for query uninsured. Sort by date Show all posts
Sunday, June 23, 2013
NJ Uninsured Fund Cracks Down on Uninsured Employers
It has been reported tat the NJ Uninsured Fund is vigorously seeking reimbursement for assessments and penalties from employers who do not have workers' compensation insurance.
In a recent case, a former employer was required to reach a deal with the NJ Attorney
General's Office to repay $111,813.00. It was reported that the former employer had to mortgage his house for repayment in order to avoid a potential 18 month prison term and a $10,000 fine in addition to the assessment.
Click here to read: Franklin Lakes business owner must mortgage home to avoid jail in workers compensation case
In a recent case, a former employer was required to reach a deal with the NJ Attorney
Click here to read: Franklin Lakes business owner must mortgage home to avoid jail in workers compensation case
Monday, April 15, 2019
Payment under section 20 invokes the exclusivity bar even if the employer is uninsured
A lump sum payment under Section 20 of the New Jersey Workers’ Compensation law is deemed to be an employee’s complete surrender of rights and therefore it is the exclusive remedy and bars a negligence action.
Wednesday, July 31, 2013
Holes in the Safety Net — Legal Immigrants' Access to Health Insurance
Immigrant workers are entitled to workers' compensation benefits in most jurisdictions even if they are in the US without status. Ongoing Congressional changes to the nation's immigration system will have significant impact on the delivery of healthcare to immigrant workers.Today's post was shared by NEJM and comes from www.nejm.org
More than 12 million immigrants are lawfully present in the United States. They serve in the military, pay taxes, and contribute to the economy. Yet like undocumented immigrants, whose health care vulnerabilities are outlined in the Perspective article by Sommers, legal immigrants face substantial barriers to obtaining insurance coverage (see graph Health Insurance, According to Citizenship Status, 2009.). As a result, some — such as Antonio Torres, an uninsured Arizona farmworker who was in a coma after a car accident — have been forcefully transferred to their native country when their treating hospitals were unable to find facilities willing to provide them with long-term care.1
Thursday, December 24, 2009
NJ Aims to Speed up Uninsured Penalties
The NJ Legislature is considering speeding up the processing of penalties and assessments against uninsured employers. Bills are pending before both houses of the legislature.
"This bill amends the workers’ compensation law to require that the Director of Workers’ Compensation shall, in any case in which an award of compensation payable by an uninsured employer or an assessment has been ordered by the director, file with the Clerk of the Superior Court a statement of the findings and judgment of the workers’ compensation judge or a certified copy of the director's order. Upon that filing, the statement or order, as the case may be, shall have the same effect and may be collected and docketed in the same manner as judgments rendered in causes tried in the Superior Court.
"Under current law, the director is not permitted to make the filing until 45 days after payment is due and 10 days after the uninsured employer fails to comply with any demand to deposit with the director the estimated value of the compensation, and 20 days after orders by the director to pay any assessments for failure to pay. The bill requires, rather than permits, the director to make the filing, and requires that the filing be made without the delays currently imposed.
.........
Click here to read more about uninsured employers and workers' compensation.
"This bill amends the workers’ compensation law to require that the Director of Workers’ Compensation shall, in any case in which an award of compensation payable by an uninsured employer or an assessment has been ordered by the director, file with the Clerk of the Superior Court a statement of the findings and judgment of the workers’ compensation judge or a certified copy of the director's order. Upon that filing, the statement or order, as the case may be, shall have the same effect and may be collected and docketed in the same manner as judgments rendered in causes tried in the Superior Court.
"Under current law, the director is not permitted to make the filing until 45 days after payment is due and 10 days after the uninsured employer fails to comply with any demand to deposit with the director the estimated value of the compensation, and 20 days after orders by the director to pay any assessments for failure to pay. The bill requires, rather than permits, the director to make the filing, and requires that the filing be made without the delays currently imposed.
Identical Bill Number: S2495 Quijano, Annette as Primary Sponsor Barnes, Peter J., III as Primary Sponsor Moriarty, Paul D. as Primary Sponsor Egan, Joseph V. as Co-Sponsor Diegnan, Patrick J., Jr. as Co-Sponsor Vas, Joseph as Co-Sponsor | ||||
| | ||||
| 1/15/2009 Introduced, Referred to Assembly Labor Committee 1/26/2009 Reported out of Assembly Committee, 2nd Reading 5/21/2009 Passed by the Assembly (76-0-0) 5/21/2009 Received in the Senate without Reference, 2nd Reading Statement - ALA 1/26/09 - 1 pages PDF Format HTML Format Introduced - 3 pages PDF Format HTML Format Committee Voting: ALA 1/26/2009 - r/favorably - Yes {9} No {0} Not Voting {0} Abstains {0} - Roll Call Session Voting: Asm. 5/21/2009 - 3RDG FINAL PASSAGE - Yes {76} No {0} Not Voting {4} Abstains {0} - Roll Call | ||||
Click here to read more about uninsured employers and workers' compensation.
Friday, May 2, 2008
Diagnosing and Curing the Ailing NJ Workers' Compensation System
On the eve the NJ Senate's investigation into New Jersey's workers' compensation system, the question lingers on how to evaluate its health. New Jersey has always had a very large and very dedicated workforce A recent newspaper series by Star-Ledger reporters Dunstan McNichol and John P. Martin revealed that the system is serious flawed and that it is in need of a “complete overhaul.”
The State has a history of being a heavily industrialized state with a huge legacy of pollution from asbestos to petrochemical. Dr. Irving J. Selikoff, of Paterson, NJ, began his landmark studies on asbestos workers in New Jersey. In 1911, almost a century ago, NJ adopted an administrative system known as workers' compensation and it was the intent of the Legislature to provide a speedy and cost effective system of delivering statutorily defined benefits to injured workers while passing the costs onto the consumers of products and services.
This will be the first major evaluation of the workers’ compensation system in 30 years. The last one resulted in a fraud report from the NJ State Commission of Investigation and subsequent statutory change.
Much has changed from the past. In 1911 modern medicine was unknown and so were the diseases that it now treats. The program’s benefits were meager and the conditions eligible for compensation were few and far between. More Americans have died from occupational disease in the United States of America in the past 40 years than in all wars dating back to 1776. Hearings on S.79 before the Subcomm. of Labor and Human Resources of the Senate Comm. on Labor and Human Resources, 100th Cong. 1st Session, S.Hrg. 100-56, pt. 1, at page 1 (1987). Collateral benefit programs did not exist: major medical insurance, long term disability, social security and pension programs.
We are experiencing a struggling economy today. Former Labor Secretary Robert Reich stated, “Fifty years ago, when over a third of the American workforce was unionized and most big industries were oligopolies, it was fairly easy for unionized workers to get higher wages and benefits without putting any individual company at a competitive disadvantage. The higher wages and benefits were merely passed on to consumers in the form of higher prices or came out of profits that would otherwise go to investors. Today, though, most companies are in fierce competition because new technologies combined with globalization have destroyed the old oligopolies and allowed many new entrants.”
Today the workers’ compensation process is confronted with the complexity of the causal relationship of new diseases to synergistic occupational exposures to complex substances as well as traumatic events. Multiple bureaucratic benefits programs that are not formally connected burden the system with claims and liens. Revenue is limited by fewer manufacturing facilities and it is more costly to provide medical treatment and pharmaceutical protocols that result in miraculous recoveries as well as serious and fatal unfortunate results. Benefits must be paid out longer since the average person has a greater life expectancy, ie 1911 – 50 yrs of age and 2007 – 78 years of age.
As in medicine, one must look at both subjective complaints and objective findings to guide its evaluation of the workers’ compensation system. One can hear the cry’s of injured workers “Waiting in Pain,” and of the injured workers and the families of those who did not survive the compensation system. Stories of frustration and outrage are reported in the press. Testimony to the NJ Senate will come from the stakeholders who have economic interests in the system and those who are organized representatives of those who are unable to speak any longer. Those voices must be heard and evaluated. It is important to heed to words and wisdom of all and evaluate them in the context of self-motivation.
The compensation system has been portrayed as, “a dead elephant in the room,” and one that fails to carry out the legislative intent of 1911. Professor Emeritus, John F. Burton, Jr., of Rutgers University of the School of Management and Labor Relations, describes the NJ system as, "It's kind of a sleepy system…” that is “…not particularly worker-friendly."
Unlike The Constitution, the workers' compensation act deals not in the theoretical and vague general concepts of Democracy. The compensation act is a document, which within its four comers, speaks with certainty, specifics and details.
The program has failed because under the present system the Legislative intent cannot be carried out. One cannot drive a 1911 model car on the NJ Turnpike today. Workers' Compensation should be viewed in that context, and not as a cash cow for any interest parties.
The Act can no longer provide medical treatment in an efficient and effective manner consistent with the legislative intent to provide social remedial benefits through a liberal and summary social insurance program. Medical coverage has become acute in NJ and in other jurisdictions. Almost a majority of workers will soon be uninsured for major medical coverage. NJ should take the initiative, as other states have, to provide for universal health care. NJ should combine workers' compensation medical coverage with a universal employer based medical care program and have a single payer system. A single payer system will be cost effective, efficient and provide more appropriate delivery of medical care.
The workers' compensation system began in 1911 with the noble mission as a social remedial system providing an efficient and certain system of benefits to injured workers. Today, the system struggles to protect employees as the rapidly evolving landscape is demanding increased attention to reconsideration of an IHC system in light of the consequences of the program's costs and the consequences of being uninsured for healthcare benefits. The participants in the current program, including employees and employers , will require a more balanced and certain medical delivery system. The lack of healthcare coverage takes an enormous toll on the uninsured, which results in avoidable deaths each year, poorly managed chronic conditions, undetected or under treated cancer and untried life-saving medical procedures. An Integrated Health Care plan is a potential national shift to reduce costs so that a healthcare safety net can be maintained for workers and their families.
“Full-time healthcare would save money. Instead of paying for two insurance plans – one to cover healthcare for injuries and illnesses on the job and another for injuries and illness off the job – businesses would buy one plan. As Roger Thompson, former director of Travelers Insurance Workers’ Compensation Strategic Business Unit put it, the present system is ‘like having two trains going down separate tracks and it doesn’t make a lot of sense to have all the administrative costs to maintain these separate systems.’” R. McGarrah, “Full-time Healthcare for America’s Working Families [Draft],” AFL-CIO (August 22, 2003).
In the short run, adopting such concepts, proposed by Senator Stephen M. Sweeney and Assemblyman Neil M. Cohen, would be fine initial steps:
The State has a history of being a heavily industrialized state with a huge legacy of pollution from asbestos to petrochemical. Dr. Irving J. Selikoff, of Paterson, NJ, began his landmark studies on asbestos workers in New Jersey. In 1911, almost a century ago, NJ adopted an administrative system known as workers' compensation and it was the intent of the Legislature to provide a speedy and cost effective system of delivering statutorily defined benefits to injured workers while passing the costs onto the consumers of products and services.
This will be the first major evaluation of the workers’ compensation system in 30 years. The last one resulted in a fraud report from the NJ State Commission of Investigation and subsequent statutory change.
Much has changed from the past. In 1911 modern medicine was unknown and so were the diseases that it now treats. The program’s benefits were meager and the conditions eligible for compensation were few and far between. More Americans have died from occupational disease in the United States of America in the past 40 years than in all wars dating back to 1776. Hearings on S.79 before the Subcomm. of Labor and Human Resources of the Senate Comm. on Labor and Human Resources, 100th Cong. 1st Session, S.Hrg. 100-56, pt. 1, at page 1 (1987). Collateral benefit programs did not exist: major medical insurance, long term disability, social security and pension programs.
We are experiencing a struggling economy today. Former Labor Secretary Robert Reich stated, “Fifty years ago, when over a third of the American workforce was unionized and most big industries were oligopolies, it was fairly easy for unionized workers to get higher wages and benefits without putting any individual company at a competitive disadvantage. The higher wages and benefits were merely passed on to consumers in the form of higher prices or came out of profits that would otherwise go to investors. Today, though, most companies are in fierce competition because new technologies combined with globalization have destroyed the old oligopolies and allowed many new entrants.”
Today the workers’ compensation process is confronted with the complexity of the causal relationship of new diseases to synergistic occupational exposures to complex substances as well as traumatic events. Multiple bureaucratic benefits programs that are not formally connected burden the system with claims and liens. Revenue is limited by fewer manufacturing facilities and it is more costly to provide medical treatment and pharmaceutical protocols that result in miraculous recoveries as well as serious and fatal unfortunate results. Benefits must be paid out longer since the average person has a greater life expectancy, ie 1911 – 50 yrs of age and 2007 – 78 years of age.
As in medicine, one must look at both subjective complaints and objective findings to guide its evaluation of the workers’ compensation system. One can hear the cry’s of injured workers “Waiting in Pain,” and of the injured workers and the families of those who did not survive the compensation system. Stories of frustration and outrage are reported in the press. Testimony to the NJ Senate will come from the stakeholders who have economic interests in the system and those who are organized representatives of those who are unable to speak any longer. Those voices must be heard and evaluated. It is important to heed to words and wisdom of all and evaluate them in the context of self-motivation.
The compensation system has been portrayed as, “a dead elephant in the room,” and one that fails to carry out the legislative intent of 1911. Professor Emeritus, John F. Burton, Jr., of Rutgers University of the School of Management and Labor Relations, describes the NJ system as, "It's kind of a sleepy system…” that is “…not particularly worker-friendly."
Unlike The Constitution, the workers' compensation act deals not in the theoretical and vague general concepts of Democracy. The compensation act is a document, which within its four comers, speaks with certainty, specifics and details.
The program has failed because under the present system the Legislative intent cannot be carried out. One cannot drive a 1911 model car on the NJ Turnpike today. Workers' Compensation should be viewed in that context, and not as a cash cow for any interest parties.
The Act can no longer provide medical treatment in an efficient and effective manner consistent with the legislative intent to provide social remedial benefits through a liberal and summary social insurance program. Medical coverage has become acute in NJ and in other jurisdictions. Almost a majority of workers will soon be uninsured for major medical coverage. NJ should take the initiative, as other states have, to provide for universal health care. NJ should combine workers' compensation medical coverage with a universal employer based medical care program and have a single payer system. A single payer system will be cost effective, efficient and provide more appropriate delivery of medical care.
The workers' compensation system began in 1911 with the noble mission as a social remedial system providing an efficient and certain system of benefits to injured workers. Today, the system struggles to protect employees as the rapidly evolving landscape is demanding increased attention to reconsideration of an IHC system in light of the consequences of the program's costs and the consequences of being uninsured for healthcare benefits. The participants in the current program, including employees and employers , will require a more balanced and certain medical delivery system. The lack of healthcare coverage takes an enormous toll on the uninsured, which results in avoidable deaths each year, poorly managed chronic conditions, undetected or under treated cancer and untried life-saving medical procedures. An Integrated Health Care plan is a potential national shift to reduce costs so that a healthcare safety net can be maintained for workers and their families.
“Full-time healthcare would save money. Instead of paying for two insurance plans – one to cover healthcare for injuries and illnesses on the job and another for injuries and illness off the job – businesses would buy one plan. As Roger Thompson, former director of Travelers Insurance Workers’ Compensation Strategic Business Unit put it, the present system is ‘like having two trains going down separate tracks and it doesn’t make a lot of sense to have all the administrative costs to maintain these separate systems.’” R. McGarrah, “Full-time Healthcare for America’s Working Families [Draft],” AFL-CIO (August 22, 2003).
In the short run, adopting such concepts, proposed by Senator Stephen M. Sweeney and Assemblyman Neil M. Cohen, would be fine initial steps:
- prohibiting the future raiding of revenue on designated workers' compensation funds (CSR-60) should be enacted;
- swifter scheduling and use of continuous trials;
- greater permanent, temporary rate and dependency [A-2499], benefits;
- rate increases [A-2498] should be enacted;
- a review of judicial appointments as recommenced in the 1974 by the State Commission of Investigation report;
- an enhanced in-service judicial training curriculum;
- exclusive jurisdiction of the Division of Workers compensation over medical fee disputes [A-2501];
- a less burdensome Uninsured Employer Fund system to shift the responsibility to the State to locate and serve responsible parties and in the alternative to carryout the mandate of the Legislature to make payment to uninsured workers and asbestos victims expeditiously and even more swiftly in exigent cases;
- an independent oversight commission [A-2503] should continuously evaluate the status and progress of this system that handles trust funds and benefits valued at over $1.8 Billion dollars per year; and
- Data Match with the Centers for Medicare and Medicaid Services to comply quickly with the Medicare Secondary Payer Act which was enacted decades ago.
By evaluating the health of the compensation system thorough an intensive analysis of both the objective findings and subjective complaints, the NJ Senate will have the opportunity to enact modern, creative and innovative solutions that will be able meet the present needs of the workers, the employers and taxpayers of State. The NJ Legislature has the opportunity to craft an up-to-date system that will cure the ailing and antiquated workers’ compensation system and embrace today’s needs and tomorrow’s future and bring the State into a new century.
Sunday, November 21, 2021
Reorganization of the NJ Division of Workers’ Compensation Announced
The NJ Division of Workers’ Compensation announced a significant reorganization. The changes are to be effective on January 1, 2022.
Monday, November 11, 2013
Worried About Costs And Unaware of Help, Californians Head Into New Era of Health Coverage
Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
As uninsured Californians head into a new era of health coverage, they're worried about costs and unaware of the help they'll get from the government, a new survey finds.
The survey, by the Kaiser Family Foundation, found that three out of four Californians who earn modest incomes and could buy government-subsidized private coverage believe, wrongly, that they're not eligible for federal assistance or they simply don't know if they qualify.  "This has been, for so long, a political debate," said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group. "We're just starting to move it into a practical reality. Now that the benefits are close at hand, there is a concerted effort to educate people about what their benefits are." California is one of two dozen states preparing to dramatically expand Medicaid, the federal-state insurance program for the poor, yet the survey found only half of newly eligible low-income Californians presume they will qualify. The nonpartisan Kaiser Family Foundation surveyed some 2,000 uninsured Californians from mid-July until the end of August, a summertime lull before a burst of... |
Tuesday, July 30, 2013
WellPoint Sees Small Employers Dropping Health Coverage
Complicating the health insurance scene is the fact that injured workers who been denied workers' compensation benefits might have no safety net under Obamacare. As the system rolls out, in those situations, the states with slow disposition rates of workers' compensation claims will become fertile jurisdictions for workers' compensation reform to remedy this injustice. Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org
1.
As the nation prepares to roll out the next phase of Obamacare, the second biggest medical insurer said Wednesday that it expects to lose members in health insurance plans sponsored by smaller employers.
“I would not call it an academic assumption at this point,” WellPoint chief financial officer Wayne DeVeydt said on a conference call with stock analysts. “We continue to see small group attrition accelerate even more as we get to the back half of the second quarter. And we expect that to continue.”
The lost customers aren’t just signing up with WellPoint rivals, according to DeVeydt. “Some of it is going into the uninsured ranks,” he said. At the same time, WellPoint expects membership gains in self-insured employer plans and in the kind of individual plans that will be sold in subsidized exchanges starting Oct.
The Obama administration recently postponed enforcement of a requirement that employers with 50 employees or more offer health coverage next year or face fines. But the delay in the “employer mandate” wasn’t the reason WellPoint gave for losing small-group members. Nor did executives respond directly to analyst’s questions about whether small employers are “dumping” workers into the subsidized individual market.
Rather, small employers have hesitated to buy coverage for next year because of uncertainties surrounding the online exchanges offering individual and small-group plans, the...
“I would not call it an academic assumption at this point,” WellPoint chief financial officer Wayne DeVeydt said on a conference call with stock analysts. “We continue to see small group attrition accelerate even more as we get to the back half of the second quarter. And we expect that to continue.”
The lost customers aren’t just signing up with WellPoint rivals, according to DeVeydt. “Some of it is going into the uninsured ranks,” he said. At the same time, WellPoint expects membership gains in self-insured employer plans and in the kind of individual plans that will be sold in subsidized exchanges starting Oct.
The Obama administration recently postponed enforcement of a requirement that employers with 50 employees or more offer health coverage next year or face fines. But the delay in the “employer mandate” wasn’t the reason WellPoint gave for losing small-group members. Nor did executives respond directly to analyst’s questions about whether small employers are “dumping” workers into the subsidized individual market.
Rather, small employers have hesitated to buy coverage for next year because of uncertainties surrounding the online exchanges offering individual and small-group plans, the...
Friday, March 25, 2011
Grizzly Bear Attack Does Not Deter Benefits Even Though Employee Was Using Marjuana
The Montana Supreme Court ordered the Uninsured Fund to pay workers' compensation benefits to an employee who was mauled by an grizzly bear even, though the worker was under the influence of marijuana at the time of the accident.
The Court held that the marjuana was not a major contributing cause of the employee's injuries.
"Non-prescription drug consumption will preclude an injured employee’s benefits if consumption was the leading cause contributing to the result, when compared to all othersSection 39-71-407(4), and -407(13), MCA. No evidence was presented regarding Hopkins’ level of impairment. The WCC [Workers' Compensation Court] aptly noted, “Hopkins’ use of marijuana to kick off a day of working around grizzly bears was ill-advised to say the least and mind-bogglingly stupid to say the most.” However, the WCC further noted that grizzlies are “equal opportunity maulers,” without regard to marijuana consumption. Without evidence of Hopkins’ level of impairment, the WCC correctly concluded that marijuana was not the major contributing cause of Hopkins’ injuries."
The majority of states permit the payment of workers' compensation benefits where the use was not the sole cause of the accident. Usually Uninsured Funds are able to obtain reimbursement directly for the employer who failed to carry workers' compensation benefits.
The Court held that the marjuana was not a major contributing cause of the employee's injuries.
"Non-prescription drug consumption will preclude an injured employee’s benefits if consumption was the leading cause contributing to the result, when compared to all othersSection 39-71-407(4), and -407(13), MCA. No evidence was presented regarding Hopkins’ level of impairment. The WCC [Workers' Compensation Court] aptly noted, “Hopkins’ use of marijuana to kick off a day of working around grizzly bears was ill-advised to say the least and mind-bogglingly stupid to say the most.” However, the WCC further noted that grizzlies are “equal opportunity maulers,” without regard to marijuana consumption. Without evidence of Hopkins’ level of impairment, the WCC correctly concluded that marijuana was not the major contributing cause of Hopkins’ injuries."
The majority of states permit the payment of workers' compensation benefits where the use was not the sole cause of the accident. Usually Uninsured Funds are able to obtain reimbursement directly for the employer who failed to carry workers' compensation benefits.
Hopkins v. Uninsured Employers Fund, et al., Docket 2011 MT 49 (MT 2011) Decided March 22, 2011
Wednesday, August 7, 2013
The Unanticipated Consequences of Postponing the Employer Mandate
Today's post was shared by NEJM and comes from www.nejm.org
The Obama administration's decision to postpone implementation of the employer mandate is the latest in a series of delays and alterations of the Affordable Care Act (ACA). But postponing the mandate — which requires larger employers to offer lower-income workers health insurance coverage similar to that available in the new insurance exchanges, on equal and affordable financial terms — may create large ripple effects. The good news is that as compared with instituting the mandate as planned, postponing it should barely increase the number of uninsured Americans after ACA implementation. But it affects other provisions, particularly the individual subsidies for purchasing insurance, and creates distorted incentives that may leave the government paying significantly more than planned.
More than 90% of Americans who obtain private health insurance today receive it through employers, but the centerpiece of the ACA's effort to make coverage more attractive to the uninsured focuses on insurance exchanges for individuals purchasing coverage directly. However, because both consumers and employers can in principle finance or obtain private health insurance in either setting, ACA provisions had to be compatible with both coverage channels. Moreover, the legislation created tax-financed subsidies for buying insurance only through the exchanges while relying largely on regulations and mandates to deal with employment-based coverage. Inevitably, this grafting of a new...
[Click here to see the rest of this article]
Tuesday, November 26, 2013
NJ Workers Compensation Rates 2014
Revision of Rates and Rating Values – Effective January 1, 2014
The Commissioner of Banking and Insurance (“Commissioner”) has approved a 3.6%
increase in rates and rating values applicable to New Jersey workers compensation and employers
liability insurance effective January 1, 2014 on a new and renewal basis. The rating components of the increase are summarized below.
PREMIUM AND LOSS EXPERIENCE
Analysis of data for the latest two complete policy years and the latest calendar-accident
year, following adjustment to present premium and benefit levels, using paid and incurred losses
separately, indicates a premium level adjustment factor of 0.979 (-2.1%) due to experience.
A trend factor of 1.055 (+5.5%) is included to recognize changing exposures and losses.
The Commissioner of Banking and Insurance (“Commissioner”) has approved a 3.6%
increase in rates and rating values applicable to New Jersey workers compensation and employers
liability insurance effective January 1, 2014 on a new and renewal basis. The rating components of the increase are summarized below.
PREMIUM AND LOSS EXPERIENCE
Analysis of data for the latest two complete policy years and the latest calendar-accident
year, following adjustment to present premium and benefit levels, using paid and incurred losses
separately, indicates a premium level adjustment factor of 0.979 (-2.1%) due to experience.
A trend factor of 1.055 (+5.5%) is included to recognize changing exposures and losses.
BENEFIT CHANGES
Effective January 1, 2014, the maximum weekly benefit with respect to all types of injuries,
except permanent partial disabilities, will be changed from $826 to $843. The minimum weekly benefit will be changed from $220 to $225. In cases involving permanent partial disabilities, the present maximum weekly benefits ranging from $220 to $826, varying on the basis of duration of disability, will be changed to $225 and $843, respectively. The minimum weekly benefit for permanent partial injuries will remain at $35. The effect of the changes to the minimum and maximum weekly benefits results in a premium level adjustment factor of 1.007 (+0.7%) due to benefits.
EXPENSES
There is need for decreases in the provisions for Loss Adjustment Expense, the Security
Fund and Bureau Expense. The changes to the expense provisions result in a premium level adjustment factor of 0.996 (-0.4%).
OVERALL PREMIUM/RATE LEVEL CHANGE
The combined effect of the above adjustment factors results in an indicated premium level
adjustment factor of 1.036 (+3.6%). The rate level adjustment is also an increase of +3.6%.
CATASTROPHE PROVISIONS
A Terrorism Premium Charge of $0.03 per unit of exposure applies to all policies except
for the exclusions in 3:9-2 and 3:9-5 of the Manual. Upward deviation from the $0.03 rate is
permissible.
A Catastrophe (Other than Certified Acts of Terrorism) Premium Charge of $0.01 per
unit of exposure applies to all policies except for the exclusions in 3:9-9 and 3:9-12 of the Manual.
CLASSIFICATION RATES
The adjustment of classification rate relativity is based on the policy experience for 2006
through 2010, as reported through the Statistical Plan. The changes in the rates for the individual
classifications including those in the Admiralty and Federal Employers Liability Act coverage are
supported by, and derived from, the experience.
There are 572 classifications in the Manual effective January 1, 2014 including the codes to
accommodate Federal employments. Eight classifications carry no rate assignment. Of the remainder, 381 will experience increased rates, the rates for 167 classes will decrease, and 16 are unchanged. There are no changes to the annual policy charges for private estate or residence employees as set forth in 3:5-12 of the Manual.
In order to comply with the decision of the Commissioner, changes in manual rates for any
classification have been limited to an increase of 15% from last year’s rate. The increase percentage applicable to non "F" classifications when coverage is provided under the United States Longshore and Harbor Workers Compensation Act remains unchanged at 50%.
MINIMUM PREMIUM FORMULA
The minimum premium multiplier is increased from 100 to 150 and the maximum
minimum premium is increased from $850 to $900. The change to premium resulting from the new
rating values in the minimum premium formula is minimal and does not impact the overall rate level.
Special minimum premiums applicable to private residence classifications and to classifications subject to Maritime or Federal Employers Liability Act coverage are not affected.
SURCHARGES
New Jersey law mandates application of separate policyholder surcharges to finance the
Second Injury and Uninsured Employers’ Funds. Based on the Department of Labor and Workforce
Development’s estimate of 2014 Fund requirements, the policyholder surcharge percentages effective January 1, 2014, on a new and renewal basis to be applied to the modified premium are:
Second Injury Fund 6.56%
Uninsured Employers’ Fund 0.00%
Effective January 1, 2014, the maximum weekly benefit with respect to all types of injuries,
except permanent partial disabilities, will be changed from $826 to $843. The minimum weekly benefit will be changed from $220 to $225. In cases involving permanent partial disabilities, the present maximum weekly benefits ranging from $220 to $826, varying on the basis of duration of disability, will be changed to $225 and $843, respectively. The minimum weekly benefit for permanent partial injuries will remain at $35. The effect of the changes to the minimum and maximum weekly benefits results in a premium level adjustment factor of 1.007 (+0.7%) due to benefits.
EXPENSES
There is need for decreases in the provisions for Loss Adjustment Expense, the Security
Fund and Bureau Expense. The changes to the expense provisions result in a premium level adjustment factor of 0.996 (-0.4%).
OVERALL PREMIUM/RATE LEVEL CHANGE
The combined effect of the above adjustment factors results in an indicated premium level
adjustment factor of 1.036 (+3.6%). The rate level adjustment is also an increase of +3.6%.
CATASTROPHE PROVISIONS
A Terrorism Premium Charge of $0.03 per unit of exposure applies to all policies except
for the exclusions in 3:9-2 and 3:9-5 of the Manual. Upward deviation from the $0.03 rate is
permissible.
A Catastrophe (Other than Certified Acts of Terrorism) Premium Charge of $0.01 per
unit of exposure applies to all policies except for the exclusions in 3:9-9 and 3:9-12 of the Manual.
CLASSIFICATION RATES
The adjustment of classification rate relativity is based on the policy experience for 2006
through 2010, as reported through the Statistical Plan. The changes in the rates for the individual
classifications including those in the Admiralty and Federal Employers Liability Act coverage are
supported by, and derived from, the experience.
There are 572 classifications in the Manual effective January 1, 2014 including the codes to
accommodate Federal employments. Eight classifications carry no rate assignment. Of the remainder, 381 will experience increased rates, the rates for 167 classes will decrease, and 16 are unchanged. There are no changes to the annual policy charges for private estate or residence employees as set forth in 3:5-12 of the Manual.
In order to comply with the decision of the Commissioner, changes in manual rates for any
classification have been limited to an increase of 15% from last year’s rate. The increase percentage applicable to non "F" classifications when coverage is provided under the United States Longshore and Harbor Workers Compensation Act remains unchanged at 50%.
MINIMUM PREMIUM FORMULA
The minimum premium multiplier is increased from 100 to 150 and the maximum
minimum premium is increased from $850 to $900. The change to premium resulting from the new
rating values in the minimum premium formula is minimal and does not impact the overall rate level.
Special minimum premiums applicable to private residence classifications and to classifications subject to Maritime or Federal Employers Liability Act coverage are not affected.
SURCHARGES
New Jersey law mandates application of separate policyholder surcharges to finance the
Second Injury and Uninsured Employers’ Funds. Based on the Department of Labor and Workforce
Development’s estimate of 2014 Fund requirements, the policyholder surcharge percentages effective January 1, 2014, on a new and renewal basis to be applied to the modified premium are:
Second Injury Fund 6.56%
Uninsured Employers’ Fund 0.00%
Thursday, July 11, 2013
Connecticut Employers Shut Down For Not Paying Workers' Compensation Insurance
Today's post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.
In these tough economic times, many companies aren’t paying basic requirements for their employees like Social Security, income taxes, unemployment, or workers’ comp. This has led states all over the country to start doing spot-checks on construction sites.Employers beware – protect your workers with workers’ compensation insurance – it’s the law, and states are cracking down. Just this week
Connecticut’s Labor’s Wage & Workplace Standards Division shut down two subcontractors who were helping to build a high-rise in Stamford, CT.
According to the state, the Virginia-based contractors couldn’t provide evidence that their employees had workers’ compensation coverage in the state of Connecticut. With unemployment high and the recession lingering, employers seem to be increasingly taking advantage of the fact that people are willing to work without appropriate coverage.
It is a real shame that these days so many people are going to work without the protections that they are due under the law.
Alleged Claim of Assault by Employer Results in a Dismissal
A car salesman, who alleged that his employer punched him in the ear, was denied workers' compensation benefits. The claimant, who presented a claim for total permanent disability, was unsuccessful, after the trial judge found the worker just not credible.
The judge, Ronald Allen, NJ Judge of Compensation, based his dismissal on the evidence, after the
employer testified that the accident never occurred the worker never filed a criminal complaint against the employer, and the the employee did not seek immediate medical treatment.
The employer's medical expert, Dr. Aragona, testified that the employee lacked complaints and the clinical neurological examination was normal.
Furthermore, the Judge found that the petitioner's expert did not take into consideration a serious prior medical condition.
The Appellate Court held that it would not disturb the trial decision as there was insufficient evidence the the trial Judge's credibility determinations were in error.
Schofel v. Route 22 Nissan, NJ App Div A-5924-11T4, Decided July 11, 2013.
The judge, Ronald Allen, NJ Judge of Compensation, based his dismissal on the evidence, after the
The employer's medical expert, Dr. Aragona, testified that the employee lacked complaints and the clinical neurological examination was normal.
Furthermore, the Judge found that the petitioner's expert did not take into consideration a serious prior medical condition.
The Appellate Court held that it would not disturb the trial decision as there was insufficient evidence the the trial Judge's credibility determinations were in error.
Schofel v. Route 22 Nissan, NJ App Div A-5924-11T4, Decided July 11, 2013.
Monday, September 16, 2013
State files charges against city business
The state Department of Labor & Industry on Friday filed criminal charges against a Wilkes-Barre business, alleging it failed to maintain worker's compensation insurance. Kus Tire Inc. at 10 Carey Ave. is charged with 100 felony counts of failing to procure worker's compensation insurance, court records say. A message left seeking comment at Kus Tire was not immediately returned. According to a criminal complaint, the business, headed by Bernard Kusakavitch, failed to have the insurance for 100 days - from Sept. 10, 2008, through Sept. 17, 2008, and again from Oct. 1, 2011, through Dec. 31, 2011. As a self-insured employer, the business was not exempt from possessing the coverage, the charges say. The complaint said an employee, Walter Booth Jr., was injured Sept. 12, 2008, and subsequently petitioned for benefits from the Uninsured Employers Guaranty Fund, which provides benefits to injured employees of uninsured employers. According to the complaint, Workers' Compensation Judge Joseph B. Sebastianelli awarded Booth benefits on May 31, 2011. Investigators filed a summons against the business Friday. The matter is scheduled for a preliminary hearing before Magisterial District Judge Rick Cronauer at 9 a.m. Oct. 31. jhalpin@citizensvoice.com comments powered by Disqus |
Related articles
- Report Recommends Raising Workers' Compensation Premiums (workers-compensation.blogspot.com)
- FL Workers' Compensation May Be Going Up (workers-compensation.blogspot.com)
- Workers compensation hike on California employers proposed (workers-compensation.blogspot.com)
- Cost Shifting vs. Cost Fixing (workers-compensation.blogspot.com)
- Illinois: Employer Convicted of a Felony for Failure to Have Workers' Compensation Insurance (workers-compensation.blogspot.com)
- Who Is Paying the Bills for Occupational Illnesses and Disease? (workers-compensation.blogspot.com)
Thursday, July 18, 2013
Governor Christie Vetoes First Responder Workers' Compensation Bill
NJ Governor Chris Christie has vetoed legislation that would would have created a presumption that of compensability for first responders who contracted cancer. He calls NJ workers' compensation system "successful" as is.
S-1778/A-1196 (Greenstein/Stender, Egan, O’Donnell, Wimberly) – ABSOLUTE - ‟Thomas P. Canzanella Twenty First Century First Responders Protection Act”; concerns workers’ compensation for public safety workers.
July 18, 2013
SENATE BILL NO. 1778
(First Reprint)
To the Senate:
Pursuant to Article V, Section I, Paragraph 14 of the New
Jersey Constitution, I am returning Senate Bill No. 1778 (First
Reprint) without my approval.
Since New Jersey’s workers’ compensation law was enacted
more than a century ago, the unique circumstances surrounding
workplace injuries of all employees – including our State’s
public safety workers – have been considered in the context of
the fact-sensitive circumstances surrounding each incident.
This time-tested process appropriately balances all facts
necessary to determine a proper compensation award. In
contrast, this bill alters that careful balance by providing
public safety workers with a presumption to workers’
compensation, rebuttable only by clear and convincing evidence.
This sweeping new standard would apply to disabilities
associated with an array of enumerated incidents and, in some
cases, disabilities not tethered to any work-related incident at
all.
As a State, we must continually recognize the selfless
contributions of our first responders. Day in and day out,
these brave women and men make enormous sacrifices in order to
ensure our collective safety, health, and well-being against all
manner of threats. That essential public service, and the costs
associated with the injuries those duties may cause, must be
administered in a responsible manner that matches our public
resources. Although this measure would likely have a
significant impact on State, local, and municipal government
budgets, the bill’s sponsors refused to obtain a fiscal analysis
or refer the bill to either house’s respective budget
committees. Regrettably, the Legislature’s failure to pursue
the responsible course of thoroughly reviewing the significant
changes to a successful and long-standing system, and the
corresponding impact of this proposal on taxpayers, prevent my
approval.
Our public safety workers are vital to our State and I am
committed to ensuring their well-being and protection. Reasoned
suggestions for improving those practices should be openly and
honestly evaluated. While I welcome a discussion on new ways to
enhance the lives of emergency responders, the truncated and
insufficient manner in which this proposal was prepared and
passed is not consistent with our responsibility as elected
representatives of all citizens.
Accordingly, I herewith return Senate Bill No. 1778 (First
Reprint) without my approval.
Respectfully,
[seal] /s/ Chris Christie
Governor
Attest:
/s/ Charles B. McKenna
Chief Counsel to the Governor
Read more about workers compensation and Governor Christie
Apr 23, 2013
“'We're going to be coming up with a package of proposals that's going to work both sides of that,' Christie told a caller on his monthly NJ 101.5 FM radio show tonight. 'The employers who may not be stepping up and meeting ...
http://workers-compensation.blogspot.com/
....
For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
....
For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
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